Differential Effects of Race and Poverty on Ambulatory Care Sensitive Conditions

Authors

Farrukh B. Hakeem, Shaw UniversityFollow
Daniel L. Howard, Shaw UniversityFollow
Timothy S. Carey, University of North Carolina
Yhenneko J. Taylor, Shaw UniversityFollow

Keywords

African Americans; Ambulatory Care Sensitive Conditions; Ambulatory medical care; Discrimination in medical care; Medicare; Poor; Poverty; Race; Social status – Health aspects

Disciplines

Community-Based Research | Demography, Population, and Ecology | Family, Life Course, and Society | Inequality and Stratification | Medicine and Health | Public Health | Race and Ethnicity

Abstract

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in high poverty areas (RR=0.97; 95% CI (0.89, 1.05)). After controlling for various indicators of area SES in multivariate analyses race differences in ACS hospitalization rates persisted. Rural neighborhoods and those with higher percent of non-high school graduates were associated with greater risk of ACS hospitalizations.

Recommended Citation

Hakeem, Farrukh B.; Howard, Daniel L.; Carey, Timothy S.; and Taylor, Yhenneko J. (2009) "Differential Effects of Race and Poverty on Ambulatory Care Sensitive Conditions," Journal of Health Disparities Research and Practice: Vol. 3: Iss. 1, Article 7.
Available at: https://digitalscholarship.unlv.edu/jhdrp/vol3/iss1/7